5 Things to Know About the First Drug to Prevent HIV

[garbon]

Busting that topic out for Marti:

http://healthland.time.com/2012/07/17/truvada-5-things-to-know-about-the-first-drug-to-prevent-hiv/

Doctors now have another weapon against HIV/AIDS in their arsenal, and it's a potent one. For the first time, the U.S. Food and Drug Administration (FDA) approved a drug treatment that will prevent infection in healthy people.

The drug, called Truvada, which is already approved for the treatment of HIV in infected patients, works by lowering the amount of virus circulating in people's blood. But clinical trials show that it can also protect uninfected high-risk people from acquiring the virus, if they take the drug daily before and after exposure.

The approval is controversial. Some public health experts argue that allowing the drug to be used for prevention will foster a false sense of security among users, leading people to believe mistakenly that they are immune to the virus and reduce their use of condoms. However, the FDA determined that the benefits of expanding the pool of people who may use Truvada to protect against HIV made it worth approving. Here's what you need to know.

Who can take Truvada?
The drug, made by Gilead Sciences Inc., is approved for healthy, uninfected people who are at high risk of contracting HIV through sex. These include sex workers and people with partners who are HIV-positive or engage in high-risk behaviors, such as using IV drugs.

How effective is the drug in preventing HIV?
In one study, healthy gay and bisexual men who took Truvada daily and were counseled about safe sex practices lowered their risk of becoming infected by up to 42%. In another study involving heterosexual couples in which one partner was HIV-positive, the uninfected partner had a 75% lower risk of contracting HIV if they took Truvada.

Does Truvada cure AIDS?
No. The drug can treat people who are infected with HIV by lowering the amount of virus in their bodies and slowing down the progression of the disease. In healthy, uninfected people, the drug can thwart HIV's ability to take hold in healthy cells and start an infection, by blocking the activity of an enzyme that the virus needs to replicate.

Why is the approval controversial?
Some experts believe that healthy people may not take the drug correctly — it needs to be taken daily to be effective — which would encourage HIV to become resistant to the medication. Public health officials also worry that people may engage in more risky behaviors when they are on the drug, believing they are protected completely against HIV, which they are not. However, patients who receive Truvada prophylactically will be expected to participate in a comprehensive HIV protection plan involving regular HIV testing, condom use and prevention counseling and support. Clinical trials have not shown that users are more likely to engage in risky sexual behavior.

Researchers also can't explain why in one study involving female sex workers, those who took Truvada to prevent HIV were not protected against infection. The authors think that the participants did not take the drug in the right doses, but it's also possible that something about the vaginal environment makes the drug less effective.

Why is the approval important?
Approving a drug to prevent HIV marks a big step toward controlling the spread of HIV and AIDS, not just in the U.S. but worldwide as well. Once Truvada is used as a preventive measure domestically, U.S.-backed AIDS programs in the developing world may also begin to roll out the pill for healthy people who are at high risk of contracting HIV. Public health experts are eager to build up all effective prevention strategies, noting that the only way to stop the epidemic is by preventing new infections as well as treating existing ones.

[Berkut]

Is there anything more revolting than the idea that something that can help people ought to be denied them because some fucking bureaucrat thinks it will "encourage risky behavior!" and therefore should be restricted?

That kind of shit makes me crazy.

I remember the HIV informational classes they gave in high school, that were largely full of known bullshit and dishonesty because kids are just too stupid to risk telling the truth.

[garbon]

I remember the HIV informational classes they gave in high school, that were largely full of known bullshit and dishonesty because kids are just too stupid to risk telling the truth.

I remember being taught in high school that anal sex was bad as that part of the body had been designed as an exit only zone.

[Admiral Yi]

Is there anything more revolting than the idea that something that can help people ought to be denied them because some fucking bureaucrat thinks it will "encourage risky behavior!" and therefore should be restricted?

That kind of shit makes me crazy.

I think it's a very reasonable concern.

[Valmy]

I think it's a very reasonable concern.

Ok I promised to be nice to you Yi.  So 

[crazy canuck]

Is there anything more revolting than the idea that something that can help people ought to be denied them because some fucking bureaucrat thinks it will "encourage risky behavior!" and therefore should be restricted?

That kind of shit makes me crazy.

It makes you crazy that public health officials are concerned that people will wrongly think the drug makes them immune?  Epecially given the title of the thread leaves one with exactly that kind of misleading and false understanding?

[garbon]

Is there anything more revolting than the idea that something that can help people ought to be denied them because some fucking bureaucrat thinks it will "encourage risky behavior!" and therefore should be restricted?

That kind of shit makes me crazy.

It makes you crazy that public health officials are concerned that people will wrongly think the drug makes them immune?  Epecially given the title of the thread leaves one with exactly that kind of misleading and false understanding?

Well it does prevent HIV - just not perfectly.

Also, I'm not so sure that there is a large intersection between people who want to engage in unsafe sex with multiple partners but don't do so because their isn't a prevention method from contracting HIV.  After all, it isn't the only STD that one can get from unsafe sex.../I figure most who want to engage in unsafe sex with multiple partners are already doing so.

In fact, the three groups they note the drug has been considered approved for - already participate in their target behaviors.

[derspiess]

I remember the HIV informational classes they gave in high school, that were largely full of known bullshit and dishonesty because kids are just too stupid to risk telling the truth.

I remember being taught in high school that anal sex was bad as that part of the body had been designed as an exit only zone.

Well, it is a bit unhealthy.  Sorry that hurt your self-esteem

[garbon]

I remember the HIV informational classes they gave in high school, that were largely full of known bullshit and dishonesty because kids are just too stupid to risk telling the truth.

I remember being taught in high school that anal sex was bad as that part of the body had been designed as an exit only zone.

Well, it is a bit unhealthy.  Sorry that hurt your self-esteem

Not that unhealthy compared to the millions of other things we do to our bodies.

[Barrister]

Is there anything more revolting than the idea that something that can help people ought to be denied them because some fucking bureaucrat thinks it will "encourage risky behavior!" and therefore should be restricted?

That kind of shit makes me crazy.

I think it's a very reasonable concern.

It's a real and growing health care concern.  There are several treatments that are effective, but are harmful if not followed correctly.  I was reading an article on it a little while ago (not connected to HIV drugs).  Experience shows that a lot of patients are not very good at following prescriptions religiously.

[sbr]

Is there anything more revolting than the idea that something that can help people ought to be denied them because some fucking bureaucrat thinks it will "encourage risky behavior!" and therefore should be restricted?

That kind of shit makes me crazy.

I think it's a very reasonable concern.

Should be reasonable to limit access to guns as well, right?

[Barrister]

Is there anything more revolting than the idea that something that can help people ought to be denied them because some fucking bureaucrat thinks it will "encourage risky behavior!" and therefore should be restricted?

That kind of shit makes me crazy.

I think it's a very reasonable concern.

Should be reasonable to limit access to guns as well, right?

Of course it is.  But you guys have a silly constitutional amendment that says you can't.

There's nothing in the constitution about drugs.

[garbon]

Is there anything more revolting than the idea that something that can help people ought to be denied them because some fucking bureaucrat thinks it will "encourage risky behavior!" and therefore should be restricted?

That kind of shit makes me crazy.

I think it's a very reasonable concern.

Should be reasonable to limit access to guns as well, right?

Those don't kill people.

Although oddly enough HIV/AIDS doesn't generally do so either if one has proper access to medications...

[crazy canuck]

Well it does prevent HIV - just not perfectly

You should work in the drug industry.  You would make a hell of a pitch man.

In one study risk of infection was lowered 42%.  And that was in a group that was using condoms - or at least told to do so.  That is a long way off from "preventing".  Given your response I can see a great deal of justification in the fear that people will begin to think that the drug really does create a kind of immunity.

Also, I'm not so sure that there is a large intersection between people who want to engage in unsafe sex with multiple partners but don't do so because their isn't a prevention method from contracting HIV.  After all, it isn't the only STD that one can get from unsafe sex.../I figure most who want to engage in unsafe sex with multiple partners are already doing so.

The concern is not that people will engage in risky behaviour such as having multiple partners or having sex with people they know have AIDs.  The concern is that people who do those things will be less likely to use condoms because they wrongly believe the drug will prevent them from getting AIDS.

[FunkMonk]

I remember the HIV informational classes they gave in high school, that were largely full of known bullshit and dishonesty because kids are just too stupid to risk telling the truth.

I remember being taught in high school that anal sex was bad as that part of the body had been designed as an exit only zone.

In my high school health class we had an instructor who openly advocated that we engage in anal sex rather than vaginal. We were awestruck.